直肠癌区域淋巴结良恶性与磁共振壁外血管侵犯相关性分析

The correlation analysis of benign and malignant regional lymph nodes in rectal cancer and extramural vascular invasion by magnetic resonance

目的通过对直肠癌患者MRI壁外血管侵犯(EMVI)及区域淋巴结良、恶性分析,探讨EMVI与区域淋巴结良、恶性相关性。方法回顾性分析2018年2月至2020年11月经手术病理证实的直肠癌患者66例,其中EMVI患者31例,根据其MRI检查及病理结果,获得MRI-EMVI、DWI区域淋巴结信号强度、病理学EMVI、肿瘤浸润程度(T分期)、区域淋巴结良恶性情况等临床病理资料,分析MRI评价EMVI准确性,MRI-EMVI、DWI淋巴结信号强度及病理EMVI与区域淋巴结良、恶性的相关性,结果MRI评价EMVI准确性81.8%;MRI-EMVI、DWI及病理EMVI与区域淋巴结良、恶性存在相关性(P<0.05)。三者其诊断效能分析,ROC曲线下面积分别为0.804、0.677和0.895。MRI-EMVI和DWI信号强度对评价区域淋巴结良、恶性准确性分别为80.3%,66.7%。结论直肠癌MRI-EMVI对评价区域淋巴结良、恶性有一定价值。

Objective To investigate the correlation between extramural vascular invasion(EMVI)by MRI and benign and malignant regional lymph node by analyzing them in patients with rectal cancer.Methods Retrospective analysis was performed on 66 patients with rectal cancer confirmed by surgery and pathology in our hospital from February 2018 to November 2020,including 31 patients with EMVI.According to their MRI examination and pathological results,Clinicopathological data including MRI—EMVI,signal intensity of regional lymph nodes on DWI,pathological EMVI,degree of tumor invasion(T stage),benign and malignant status of regional lymph nodes were obtained.Accuracy of MRI evaluation of EMVI,correlation between MRI-EMVI,signal intensity of DWI lymph nodes and pathological EMVI and benign and malignant status of regional lymph nodes were analyzed.Results The accuracy of MRI evaluation of EMVI was 81.8%;MRI—EMVI,DWI and pathological EMVI had statistically significant correlation with benign and malignant regional lymph nodes(P<0.05).The area under the ROC curve was 0.804,0.677 and 0.895 respectively by analyzing the diagnostic efficacy of the three.The accuracy of MRI—EMVI and DWI signal intensity in evaluating regional lymph node benign and malignant was 80.3%and 66.7%respectively.Conclusion The MRI—EMVI status of rectal cancer has a certain value in the evaluation of benign and malignant regional lymph node.